Prolapsing haemorrhoids (piles). Piles are swollen veins in the lining of the anus. They can be caused by straining to pass hard faeces and by pregnancy. When piles protrude outside the anus they are deemed to be prolapsing. Symptoms are rectal bleeding and pain on defecation. With prolapsed haemorrhoids there is the additional risk of thrombosis and strangulation (decreased blood flow in a vein due to clotting). These are grade 4 haemorrhoids, the most severe level of internal hemorrhoids, which are usually treated with surgery.
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